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Videosurgery and Other Miniinvasive Techniques
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2/2023
vol. 18
 
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Thoracic surgery
abstract:
Original paper

Computed tomography-guided indocyanine green localization of multiple ipsilateral lung nodules

Jia Lin
1
,
Long-Fei Wang
2
,
Anle Wu
1
,
Fei Teng
1
,
Yu-Tao Xian
2
,
Rui Han
1

  1. Department of Interventional Radiology, Ningbo First Hospital, Ningbo, China
  2. Department of Thoracic Surgery, Ningbo First Hospital, Ningbo, China
Videosurgery Miniinv 2023; 18 (2): 305–312
DOI: https://doi.org/10.5114/wiitm.2023.124272
Online publish date: 2023/01/17
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Introduction
Approximately 20% of lung nodule (LN) patients have more than one moderate-to-high malignant risk LNs. When performing one-stage video-assisted thoracoscopic surgery (VATS) in patients with multiple LNs, the ability to simultaneously localize all of these nodules is critical to operative success.

Aim
To explore the efficacy and safety of computed tomography (CT)-guided indocyanine green (IG) localization for multiple ipsilateral LNs.

Material and methods
This was a retrospective study of 278 LN patients who underwent CT-guided IG localization prior to VATS resection. Of these patients, 68 underwent localization of multiple ipsilateral LNs, whereas 210 underwent localization of a single LN.

Results
Results: In total, 160 LNs were localized in 68 patients in the multiple localization group, while one LN was localized for each of the 210 patients in the single localization group. A 100% technical success rate was achieved in both of these groups, and the mean respective localization durations in the multiple and single LN groups were 11.3 ±4.7 min and 6.3 ±2.7 min (p = 0.001). Of the patients in the multiple and single LN groups, 22 and 15, respectively, experienced pneumothorax (p = 0.001), while 14 and 20 experienced lung hemorrhage (p = 0.016). Wedge/segmental LN technical success rates in both of these groups were 100%.

Conclusions
The CT-guided IG-mediated localization of multiple ipsilateral LNs is a safe and effective strategy, although it requires a longer operative duration and is associated with higher rates of adverse events as compared to single nodule localization.

keywords:

indocyanine green, localization, multiple, lung nodules
  
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